Factors That Influence the Mortality Rate Among Individuals Who are Over 65 Years Old and Utilize Home Health Care Services

Nida Ayhan, Pemra C. Unalan, Büşra Çimen Korkmaz

Keywords: Elderly, Mortality, Home Health Care services

Mortality and morbidity of elderly people have become more important due to the increasing elderly population. So investigating the conditions that affect the mortality of the elderly and determining the factors affecting survival is getting important.

Research questions:
To determine the conditions affecting mortality in patients aged 65 years and over utilizing home health care.

In this retrospective cohort study, sociodemographic characteristics of patients 65 years and older who were first registered to Marmara University Home Care Services between January-December 2018, the time interval they stayed in-home care, chronic diseases, drug numbers, fall risks, cognitive situations, daily life activity scores, presence of pressure sores, incontinence, sociodemographic characteristics of the caregiver, and the date of death were collected. Descriptive and comparative analyzes were performed and p<0.05 was considered statistically significant.

Of all 67.7% were female. The median age was 81 years. 159 patients died while utilizing home care. The average number of days in-home care services was 313.49 (min:0 max:572) days. Mortality was found to be related to male sex, malignancy, gaita incontinence, daily living activity score, and fall risk score. In survival analysis, men have a 1,407-fold higher risk of mortality than women (95% G.A:1,008-1,963). Those with a diagnosis of malignancy had 3,489 times higher mortality than those without (95% G.A:2,341-5,200). The mortality risk is 2.093 times higher in patients with gaita incontinence (95% G.A:1,332-3,290). A one-unit increase in the total score of daily living activity reduces the risk of mortality by 0.735 times (95% G.A:0,603-0.895). The high fall risk is 2,869 times higher mortality than those with low risk (95% G.A:1,795-4,588).

The geriatric syndromes and malignancies are associated with old age and build a significant portion of the causes of mortality and morbidity. To improve the quality of relationships between the elderly and primary care may help the elderly patients.

Points for discussion:
Which further analysis can be applied?